Consider This from NPR - What Contact Tracing Tells Us About High-Risk Activities

Episode Date: May 20, 2020

Three-quarters of Americans are concerned that a second wave of coronavirus cases will emerge, a new NPR/PBS NewsHour/Marist poll finds. Despite that, groups around the country, including in Michigan, are protesting state lockdowns. President Trump's stance on hydroxychloroquine has made the drug harder to study, according to some scientists. Researchers have been digging into contact tracing data from countries that had early outbreaks. Data suggest high risk activities include large indoor gatherings. Lower risk is going to the grocery store.Plus, what is happening with classroom pets when school is out of session due to the coronavirus. Reporter Sara Stacke's story with photos.You can hear more about the NPR poll on the NPR Politics Podcast on Apple Podcasts, Spotify and NPR One.Find and support your local public radio stationSign up for 'The New Normal' newsletterThis episode was recorded and published as part of this podcast's former 'Coronavirus Daily' format.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Reopening, and doing it safely, is possible. I can't find a person in this country who wants to see another person die unnecessarily. And I haven't met a person in this country that doesn't want people to get their jobs back and open up the economy again. Former Obama administration health care official Andy Slavitt is part of a bipartisan group of public health experts who are urging state and local leaders to better follow plans for testing, tracing, and isolating new cases. The truth is, you know, you're in the middle of this learning process and you have to be very safe but understand that nothing is going to be risk-free. Slavitt says to minimize that risk, new, more detailed guidelines released by the CDC this week are a good start.

Coming up, scientists are learning about where you are more likely to catch the virus. This is Coronavirus Daily from NPR. I'm Kelly McEvers. It's Wednesday, May 20th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit WISE.com. T's and C's apply. So, do you expect life to get back to normal in the next six months? 65% of Americans say no. That's according to a new poll by NPR, PBS, NewsHour, and Marist.

As for a second outbreak, three-quarters of Americans are worried about that. That number might sound surprising given all the coverage of protests like this one in Michigan a few weeks ago. People who opposed stay-at-home orders were trying to get into the Capitol. Now in Michigan, there is a different kind of public health emergency. Catastrophic flooding in the Midwest. Central Michigan, one of the hardest hit areas after at least two dams have collapsed under the force of days of torrential rains. Around the same time, those dams collapsed. President Trump was posting on Twitter and falsely claiming that Michigan had mailed out millions of absentee ballots. He later corrected the tweet. What actually happened was that Michigan had mailed out applications for ballots, encouraging people to vote by mail if they want to.

Something that happens all the time in red and blue states. Research shows mail-in voting doesn't favor one party or the other, and voter fraud by mail is extremely rare. NPR's poll found, given the pandemic, a majority of both Democrats and Republicans would rather avoid a polling place this November. OK, let's talk about the drug hydroxychloroquine. It's been around for decades and it is an effective treatment for a number of diseases, though it can have serious side effects. Scientists had started to test it against the coronavirus, but before there was any evidence that it worked, the president started promoting it. He even said this week he's taking it. I happen to be taking it. I happen to be taking it. Hydroxychloroquine? I'm taking it. Hydroxychloroquine? I'm taking it,

hydroxychloroquine. When? Right now, yeah. A couple of weeks ago, I started taking it. Because I think it's good. I've heard a lot of good stories. Reporter Will Stone says all of this is complicating the research. Dr. John Giles didn't expect to have problems drumming up interest in his clinical trial for hydroxychloroquine. Giles is at Columbia University, and he was all set to start enrolling patients at the end of April, but ran into a problem. Pretty much everybody said, well, that's the drug that is dangerous to your heart. Or I talked to friends and they said, don't take it. Or I saw it on TV that it was dangerous.

Weeks earlier, people were clamoring to enroll. But the news changed. One study of hospitalized veterans found the drug did not reduce the need for a ventilator. It even linked hydroxychloroquine to higher death rates. But that wasn't a rigorous, controlled trial, and the results hadn't been peer-reviewed. Then, more news. The FDA issued a warning about using the drug for COVID-19 patients. It became almost impossible to get anyone interested. Giles had wanted to study its protective potential,

giving it to people after someone in their household tested positive. And he's comfortable with hydroxychloroquine. As a rheumatologist, he prescribes it to patients with lupus and arthritis. It's a very, very safe drug. It's been used for over 75 years. Giles eventually gave up on doing his study. Other scientists have had similar problems. Dr. Christine Johnston is at the University of Washington, where there are several clinical trials.

We're hearing now from some participants that the study and the drug feel too political, and they just don't want to participate at all. The controversy even set back recruitment for a Detroit-based study by a month. At the Henry Ford Health System, Dr. William O'Neill is researching whether hydroxychloroquine can be used to prevent infection among health care workers. Everything that we see about hydroxychloroquine suggests that the earlier you use the drug, the more likely it is to be effective. And that's a very different question, he says, than whether the drug works for people who are seriously ill or on a ventilator.

But he feels that important distinction is getting lost. O'Neill says the fact that President Trump is touting this drug means some people are now invested in the idea that hydroxychloroquine won't work. And the problem with that is this is not politics. This is life and death. We're talking about a treatment. Who would be rooting for us not to find a therapy, for God's sakes? O'Neill says it's good to study hydroxychloroquine because it has such a long track record. At Vanderbilt, Dr. Wesley Self is studying the drug in sick, hospitalized COVID patients. He gets that the country is sort of on an emotional roller coaster when it comes to this drug.

This is a perfect situation for a clinical trial to really understand what the balance of those benefits and risks are. At Duke University in North Carolina, Dr. Susanna Nagy is studying hydroxychloroquine as a way to prevent infection in health care workers. I do worry that there are many well-controlled trials that are underway where we won't get an answer. And that would be, I think, a shame. Nagy says the best thing we can do right now is try to get some clear answers. And that takes time. Reporter Will Stone. Countries around the world are getting better at contact tracing,

finding out who is infected and isolating their close contacts. That helps slow the spread of the virus. But it also gives researchers a better idea of how people are catching it in the first place. Dr. Muga Cevik is an infectious disease specialist at the University of St. Andrews in Scotland. She told All Things Considered host Ari Shapiro, some behaviors are riskier than others. So after examining this series of contact tracing studies from all around the world, what we can say that there are some trends. I know people

regularly worry about grocery stores, bike rides, and runners. But what we can say so far is most of the spread happens in groups of adults, and usually indoors. And the majority of risk is, you know, in crowded environments with stagnant air. When you say the majority of risk, are we talking about 40% transmission versus 60% transmission or more like 90% to 10%? So I guess it's more like majority of infections are occurring in these environments. Almost 80% of infections are caused by really small number of patients. Yeah, I was shocked to read this, that like 80% of transmissions are caused by 9% of infected people.

I mean, that's shocking to me. Can you explain that? So this is mostly about the behavior involved. So if an infected person, when they're the most infectious, go to a big event where many people gather together, spend time together, then many people can be exposed and also infected. A big event like a funeral or a birthday party or a church service. Exactly. As you looked over these studies, what jumped out to you as specific cases of widespread infection and perhaps places where it was not as widespread

as the fear and anxiety might have suggested? So there was a recent study from China where they identified an infected case who's working in the supermarket, and they followed up almost 8,000 contacts of this person. What they found was if you're a supermarket client, your chance of getting infected is 0.02%. So it's very, very low. But whereas if you're a supermarket employee, because you're exposed multiple times, your risk of getting infected might be 9%. If you're a family member of an infected person, your risk of infection is 12%. So I think we just need to give a range of different risks to people. So outdoors is definitely safer than indoors. Non-peak hours is safer than peak hours.

And non-crowded areas safer than very crowded areas. How does this new understanding of what activities are high versus low risk change the way we think about basic precautions like hand washing, mask wearing, social distancing, things like that? Yeah, I mean, I guess like what I feel is that at the end of the day, we need to learn how to live with this virus. And if we could provide individuals with this information, people will be more aware of their actions in general. Because we can't completely eliminate the risk. We can minimize the risk. So this is, I think, really crucial.

Dr. Muga Cevic with All Things Considered host Ari Shapiro. Scott Kefchin teaches first grade in Michigan. He, of course, is not at school these days. Neither are the pets who he usually keeps in the classroom. I have a gerbil named Oreo, a tank with three fire belly toads, jumping jacks, lily pad, and hopscotch, our leopard geckos, Archie, Betty, and Veronica. And I also have two yellow belly cooter turtles named Peanut Butter and Jelly. The animals now take up most of Scott's living room. He says it's another thing to talk about with his students remotely. It's a great reminder of the privilege I have to be with my students every day.

And it's also a great source of connection that I still have with my students. In Brooklyn, first grader Aram Agha has taken in his classroom pet, Holly the tortoise. And I hear her right now crawling. His mom says when this is all over, he'll have to get one of his own. These voices and more were collected by our colleagues at All Things Considered. And photographer Sarah Stack has a big feature on students, teachers, and their classroom pets at home. You can see it on our website at the link in our episode notes. For more on the NPR poll, check out the NPR Politics Podcast. And you can stay up to date with all the news on your local public radio station. I'm Kelly McEvers. We'll be back with more tomorrow. This message comes from NPR sponsor CNN. Each day on the Coronavirus Fact vs. Fiction podcast,

Dr. Sanjay Gupta answers your questions around COVID-19. Check out Coronavirus Fact vs. Fiction on NPR One or wherever you get your podcasts.